Oncotype and Pam 50 are both intermediate! Help!!!
Ladies!
My Oncotype and Pam 50 test came back intermediate!!! Idk if my insurance will pay for another test if I want to get a Mammaprint test done! I wish my Dr would of ran that instead but I didn't know about it!! What should I do
Comments
-
SF, Idk what the PAM 50 is, but I believe that the mamma-print is ordered if you have an intermediate onco score. I was a 21 and my MO offered it, but I chose not to do it bc of the wait. Just wanted to get started on my TX. Good luck!
-
I believe if your insurance company refuses payment for a Mammaprint, or you wish to go self-pay, the cost is $500 for the patient. You might PM the member Lisey, she sought Mammaprint after an intermediate Oncotype Dx, and I believe that was her out of pocket cost.
-
Your choices now are to get a second and/or third opinion, see if you can get mammaprint, or make a decision. I know these are hard decisions; it would be so much easier if we had a crystal ball to know what our future holds. I find that making a list of paper of the pros and cons of my choices helps to make it clearer for me. Best wishes. Keep us posted.
-
Hi Sunflower64:
Please discuss the meaning of this latest result with your MO. Possible questions include:
(1) Why was this test selected in my particular case versus another test, such as MammaPrint? Are there possible advantages, for example based on the output, patient populations in which the test was validated, or other factors?
(2) Was the test conducted the Prosigna version of PAM50? (i.e., Prosigna Breast Cancer Prognostic Gene Signature Assay; NanoString Technologies, Seattle, WA) Please obtain a complete copy of the test report for your review and records.
(3) What was my ROR score? What is the risk of recurrence associated with this score? What type of risk estimate is that (e.g., 5 year? 10 year? Distant? other?)
(4) Does the test result also provide information about "intrinsic subtype" (e.g., Luminal A, Luminal B, others)? If so, what are the implications of having this subtype?
(5) In light of relevant clinco-pathologic features, the Oncotype RS, PAM50 ROR, and intrinsic subtype information (if applicable), what is your recommendation regarding adding chemotherapy?
You mentioned in another thread that your Oncotype Score is 27. I am still not clear on your actual lymph node status (N0 or N1mi). If you are not sure, please check your pathology report for stage or TNM information (e.g., pT1 NX MX) or ask your MO to explain your exact stage and lymph node status.
If you are purely node-negative "N0", please see this discussion of intermediate Oncotype scores:
https://community.breastcancer.org/forum/147/topics/842209?page=3#post_4768276
The above post includes a link to this page with a graph based on the node-negative ("N0") studies of Paik (2004) and Paik (2006), and which you should discuss with your MO or a second opinion MO:
Please understand that these tests are based on comparisons of groups of patients. They can provide population-based "prognostic" (e.g., recurrence risk) information and may sometimes provide population-based "predictive" information (regarding benefit of added chemotherapy), that can assist in decision-making. However, such tests do not predict individual outcomes.
BarredOwl
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team